1340-P: Complications 30 Years from Diagnosis amongst Participants in the Cognition and Longitudinal Assessment of Risk Factors over 30 Years (CLARiFY) Study

There are few longitudinal cohort studies in type 1 diabetes that originate in the immediate post-DCCT era. We recruited participants who had initially presented with childhood onset type 1 diabetes (<15 yr age) to a tertiary hospital in Australia between 1990-1992 into the Cognition and Longitudinal Assessment of Risk Factors over 30 Years (CLARiFY) Study. Microvascular co-morbidity outcomes were measured using a clinical neuropathy screening tool and spot urinary albumin to creatinine ratios (ACR). In this interim study, 56 participants had complete neuropathy screening. 7/56 (12.5%) met the criteria for neuropathy with the mean (SD) HbA1c of 8.57 (1.49) compared to 8.04 (1.46) in the non-neuropathy participants (p-value=0.41). Pearson's correlation coefficients were calculated to assess pairwise associations between HbA1c and continuous neuropathy outcomes and observed non-significant negative correlations between HbA1c and vibration (r=-0.12, P=0.38). Of the 56 participants with neuropathy measurements, 40 also had urine albumin-creatinine ratios (ACR). 27/40 (67.5%) had normal ACR (ACR<3 mg/mmol) with HbA1c of 7.8 (1.3); 10/40 (25.0%) had microalbuminuria (3 mg/mmol<ACR<30 mg/mmol) with HbA1c of 10.3 (2.3); and 3/40 (7.5%) had macroalbuminuria (ACR>30 mg/mmol) with HbA1c of 10.3 (2.3). Using a one-way ANOVA test, HbA1c was significantly different between the three groups (p-value = 0.01.). Using the ACR as a continuous variable, the Pearson's correlation coefficient with A1c was 0.49 (p-value= 0.001). Collectively, these data show that in a cohort of type 1 adults diagnosed in childhood, elevations of ACR are more common and associate with glycemic control when compared to measures of neuropathy.